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Barriers to Providing Mother's Own Milk to Extremely Preterm Infants in the NICU

Fernández Medina, Isabel María PhD, RN; Fernández-Sola, Cayetano PhD, RN; López-Rodríguez, María Mar PhD, RN; Hernández-Padilla, José Manuel PhD, RN; Jiménez Lasserrotte, María del Mar PhD, RN; Granero-Molina, José PhD, RN

Section Editor(s): Parker, Leslie A.

doi: 10.1097/ANC.0000000000000652
Human Milk Science: Special Series
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Background: Mothers' own milk (MOM) has more than nutritional benefits for extremely preterm infants (<28 weeks). However, mothers encounter barriers that make it difficult to provide their own milk to their extremely preterm infants.

Purpose: The aim of this study was to describe and understand the experiences of mothers of extremely preterm infants regarding barriers to providing their own milk during infant hospital stay in the neonatal intensive care unit (NICU).

Methods: This study followed a qualitative, interpretative design using Gadamer's hermeneutic approach and included 15 in-depth semistructured interviews. The data were analyzed using a modified form of the steps described by Fleming.

Results: Fifteen mothers of extremely preterm infants participated in the study. The following themes were extracted from the data analysis: (1) “unexpected and unusual lactation,” including the subthemes “the extremely preterm birth and the decision to provide MOM,” “the battle to produce milk,” and “my job was to make milk”; and (2) “providing MOM to a tiny infant in an unknown technological environment,” with the subthemes “the limitations of providing MOM in the NICU” and “the difficulties of having an extremely preterm infant.”

Implications for Practice: To provide MOM to an extremely preterm infant, there is a need for informational and practical counseling by neonatal nurses educated in breastfeeding according to mothers' requirements and emotional needs.

Implications for Research: Future research may analyze the parents' and neonatal nurses' experience about facilitators to improve MOM provision and the influence of women's sociodemographic characteristics in providing MOM to the extremely preterm infants.

Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almería, Spain (Drs Fernández Medina, López-Rodríguez, Jiménez Lasserrotte, and Granero-Molina); Faculty of Health Sciences, Universidad Autónoma de Chile, Temuco, Chile (Drs Fernández-Sola and Granero-Molina); and Adult, Child and Midwifery Department, School of Health and Education, Middlesex University, London, United Kingdom (Dr Hernández-Padilla).

Correspondence: Isabel María Fernández Medina, PhD, RN, Department of Nursing, Physiotherapy and Medicine, University of Almeria, Carretera Sacramento s/n 04120 La Cañada de San Urbano, Almería, Spain (isabel_medina@ual.es).

Institution: University of Almería.

This work was supported in part by Health Science Research Group (CTS-451).

The authors declare no conflicts of interest.

© 2019 by The National Association of Neonatal Nurses